Individual provider Active NPI

Sage J O'Brien, CSW, LSAC

  • Clinical Social Worker
  • Sandy, UT
National Provider Identifier
1275848699
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6573731-3502 Issued in UT
Practice address
230 W Towne Ridge Pkwy Ste 225
Sandy, UT 84070-2113
Phone
(801) 669-1269
Fax
(801) 669-5889
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6573731-3502 UT Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6573731-6006 UT

Addresses

Primary practice location

230 W Towne Ridge Pkwy Ste 225
Sandy, UT 84070-2113

Mailing address

230 W Towne Ridge Pkwy Ste 225
Sandy, UT 84070-2113
Phone (801) 669-1269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6573731-6006UTMDAddiction (Substance Use Disorder) Counselor
6573731-3502UTMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1275848699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W TOWNE RIDGE PKWY STE 225",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702113",
            "telephone_number": "801-669-1269",
            "fax_number": "801-669-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W TOWNE RIDGE PKWY STE 225",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702113",
            "telephone_number": "801-669-1269",
            "fax_number": "801-669-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SAGE",
        "middle_name": "J",
        "credential": "CSW, LSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6573731-3502",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "6573731-6006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.